Ilium osteitis as the main manifestation of the SAPHO syndrome: response to infliximab therapy and review of the literature |
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Authors: | Moll Concepción Hernández M Victoria Cañete Juan D Gómez-Puerta José A Soriano Alex Collado Antonio Sanmartí Raimon |
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Institution: | Arthritis Unit, Rheumatology Department, Hospital Clínic, University of Barcelona, Barcelona, Spain. |
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Abstract: | OBJECTIVE: To analyze the clinical efficacy of anti-tumor necrosis factor (TNF)-alpha therapy in the SAPHO (synovitis, acne, pustulosis, hyperostosis, osteitis) syndrome. We describe 2 new cases with ilium osteitis as the main SAPHO syndrome feature and review reported cases treated with anti-TNF-alpha. METHODS: A literature search of SAPHO syndrome cases treated with TNF-alpha blocking therapy with special emphasis on osteoarticular and skin responses was performed. RESULTS: Eighteen cases were identified: 17 SAPHO syndrome and 1 chronic recurrent multifocal osteomyelitis, a juvenile variant of SAPHO syndrome. Sixteen were reported cases and 2 were nonreported cases seen in our arthritis unit. Sixteen patients received infliximab and 2 received etanercept, with an early, sustained clinical improvement in most cases. CONCLUSIONS: Anti-TNF-alpha therapies are effective treatment for patients with refractory SAPHO syndrome, not only for cutaneous lesions but also for persistent bone lesions such as osteitis. |
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Keywords: | SAPHO syndrome Ilium osteitis Palmoplantar pustulosis Infliximab Tumor necrosis factor alpha blockers |
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